Charge nurses

My ICU is also a 16 bed SICU. Our charge nurse does not have an assignment. With 16 patients, someone is going to need a hand somewhere. Hopefully this will not change as we go into a recession and budget becomes a bigger issue.

When I started, the unit was only 8 beds and the charge nurse did have an assignment. It was usually a light assignment as possible. Back then, only experienced ICU nurses were hired, so the small unit didn't seem to need a charge nurse without an assignment.

I'm a night shift charge and I take a full assignment. In fact, we've got a lot of new nurses right now so I end up taking the sickest patients a lot of times. On days the charge does not take an assignment, helps out around the unit, responds to codes, rapid responses, bed meetings, etc... 18 bed unit. Our boss tends to do all of her budget savings on nights, we don't even have a secretary on nights...... Total BS, but it won't ever change and I don't have to deal with it much longer.

I'm a night shift charge and I take a full assignment. In fact, we've got a lot of new nurses right now so I end up taking the sickest patients a lot of times. On days the charge does not take an assignment, helps out around the unit, responds to codes, rapid responses, bed meetings, etc... 18 bed unit. Our boss tends to do all of her budget savings on nights, we don't even have a secretary on nights...... Total BS, but it won't ever change and I don't have to deal with it much longer.

Same here. Also I tend to be singled with the sicker patients. We also have lots of new nurses soon coming to nights. I have a hard time trying to be resource person, assign beds, go to CT or MRI myself,etc. We don't have a secretary either. Tried to get one and was told we didn't need one. I think our boss needs to work nights with us.

All your boss knows is numbers because that's what she/he has to report to administration. So unless there is some research which shows this is the better way to go and can either reduce length of stay thus saving money or increase patient satisfaction thus increasing the amount of hospital customers and ultimately hospital revenue then nothing will probably change. Everything boils down to money and unless the books can be affected then nothing will probably change. I think it's sad that money is the bottom line rather than patient safety or nurse satisfaction but it's the truth and something we have to deal with.

Yep that is so true.

On day shift, our charge does not take patients, but on nights, they take full assignments. We all take turns being the charge nurse.

We also respond to only code blues and not rapid responses.

In another hospital i work in, we take full assignments and responds to all problems within the hospitla plus I do all the orientation of new staff

We take a full assignment, we have 16 beds, plus another 8 that are open as needed...so we get a full assignment, and the rapid response too. They do try to give us the lighter load, but you all know how that light load can very quickly turn into the busiest pair in the unit! We have a great team and management that is more than willing to come take patients and help us out when we are drowning!

In the 14 bed unit I work in we try not to have the charge take patients. It really depends on the overall acuity of the patients though. If it is low acuity, some nurses are tripled so that the charge has no patients. Of course this has never happened when I've been charge; it just so happens I always end up with a full load along with all the headaches of being charge

In our 15 bed SICU, the charge doesn't take patients, and we usually have a resource RN as well, to help out with transfers, turns, new staff, covering for breaks, etc. There is some talk that the rapid response nurse will be an actual budgeted item this next year to allow someone to be out of staffing to fill that role.

Additionally, we have an HCP (secretary) and usually a CNA.

California........you gotta love it.

In our 15 bed SICU, the charge doesn't take patients, and we usually have a resource RN as well, to help out with transfers, turns, new staff, covering for breaks, etc. There is some talk that the rapid response nurse will be an actual budgeted item this next year to allow someone to be out of staffing to fill that role.

Additionally, we have an HCP (secretary) and usually a CNA.

California........you gotta love it.

Making note to move to California!

I work in a 26 bed MICU. Our charge nurses never takes an assignment on day or night shift. Then another nurse, who has a full assignment, is the designated "Code Nurse Coordinator" and responds to all the codes.

Why would the nurse with an assignment and not the charge nurse be code nurse coordinator? That seems crazy.

We are still told that we only have 16 beds so we can't be without an assignemnt. I guess I will never be able to explain how crazy it can be to be charge and have a full pt load, and be the "problem solver".